连续性血液净化治疗多器官功能障碍综合征的临床疗效分析

Clinical Analysis of Continuous Blood Purification Therapy on Patients with Multiple Organs Dysfunction Syndrome

目的:回顾性分析连续性血液净化在治疗多器官功能障碍综合征患者中的疗效及影响预后因素分析。方法:采用连续性血液净化治疗多器官功能障碍综合征患者54例,应用连续性动-静脉血液滤过4例,连续性静-静脉血液滤过14例,连续性动-静脉血液透析滤过7例,连续性静-静脉血液透析滤过26例,连续性血浆滤过吸附3例。治疗期间随时监测血压、心率、中心静脉压等生命体征,观察患者治疗前后肾功能、血电解质及酸碱平衡的变化。结果:54例中死亡21例,存活33例,治疗前后的血压、心率无明显变化,肾功能、血电解质、酸碱平衡等各项指标均有明显好转(P<0.05),死亡原因与连续性血液净化方式、年龄、原发病及疾病严重程度等因素有关。结论:连续性血液净化治疗能有效清除毒素、炎症介质和纠正水、电解质、酸碱紊乱,明显提高多器官功能障碍综合征患者的存活率。

Objective ：To retrospectively analyze the effect of continuous renal replacement on multiple organ failure, and the factors affecting prognosis. Methods Fifty-four cases were treated with continuous renal replacement recent years in our hospital including continuous arteral-venous hemofiltration in 4 case,continuous venous-venous hemofiltration in 14 cases,continuous arteral-venous hemodialysis filtration in 7 cases,continuous venous-venous hemodialysis filtration in 26 cases and continuous plamas filtration absorption in 3 cases.Results Among 33 patients were cured.BUN,Cr,edema, electricity and acid-base disturbance of 54 patients were well controlled.The death causeswere much concerned to age,severity of disease and otherfactors. Conclusion Continuous renal replacement could clearly eliminate BUN,Cr and edema with stable hemodynamics and it is an effective method for multiple organ failure.